Spinal Stenosis – Causes, Symptoms, Diagnosis, And Treatment
What is spinal stenosis?
Spinal stenosis is a condition of narrowing of the spinal canal. The spinal canal is the space in the spinal column, through which spinal cord passes. Spinal stenosis can exert pressure on the spinal cord and compress the nerves within the spine. This condition commonly occurs in the neck and lower back.
What causes spinal stenosis?
Spinal stenosis is often caused by age-related wear and tear. As a person’s age advances, the spinal disks become drier and start to bulge. The bones and ligaments of the spine thicken or grow larger. This is caused by arthritis or chronic inflammation.
The following are the causes of spinal stenosis:
- Arthritis of the spine in middle-aged or older people
- Bone diseases, such as Paget’s disease
- Congenital defect or growth in the spine
- Congenital narrow spinal canal
- Past history of herniated or slipped disk
- The injury that causes pressure on the nerve roots or the spinal cord
- Tumors in the spine
- Fracture or injury of a spinal bone
What are the symptoms of spinal stenosis?
Symptoms of spinal stenosis depend on the location of the narrowing. Sometimes, there are no symptoms. If and when symptoms begin, they start slowly and get worse over time. Symptoms are more likely to be present or get worse when you stand or walk. They often lessen or disappear when you sit down or lean forward.
The following are the common symptoms of spinal stenosis:
- Numbness, cramping, or pain in the neck, shoulders, arms, or lower back
- Numbness, cramping, or pain in the buttocks, thighs, or calves
- The weakness of part of a leg or arm
The following are more serious symptoms of spinal stenosis:
- Difficulty or poor balance when walking
- Problems controlling urine or bowel movements
How is spinal stenosis diagnosed?
Your doctor will perform a physical exam and review your symptoms. The physical exam focuses on finding the location of the pain and how it affects your movement. Your doctor will move your legs in different positions, including bending and straightening your knees. This helps your doctor to check your strength and ability to move.
The doctor may also do the following:
- Ask you to sit, stand, and walk. While you walk, you may be asked to try walking on your toes and then your heels.
- Ask you to bend forward, backward, and sideways to see if your pain worsens with these movements.
- Ask you to lift your legs straight up while lying down. If the pain is worse when you do this, you may have sciatica, especially if you also feel numbness or tingling in one of your legs.
- Test your nerve function and reflexes with a rubber hammer. Touch your legs in many places with a pin, cotton swab, or feather to test how well your nerves sense feeling.
- Ask you to close your eyes while keeping your feet together to check your balance.
The doctor will do a neurologic (brain and nervous system) examination to help confirm leg weakness and loss of sensation in the legs. He/she may do the following tests:
- Spinal MRI or spinal CT scan
- X-ray of the spine
How is spinal stenosis treated?
Treatment of spinal stenosis includes physiotherapy, medications, and possibly surgery.
Your doctor will help you manage your pain and keep you as active as possible by the following treatment methods:
- Referral to physical therapy. The physical therapist will teach you stretches and exercises to strengthen your back muscles.
- Referral to a chiropractor, a massage therapist, or acupuncture. Sometimes, a few visits will help your back or neck pain.
- Recommend cold packs and heat therapy to help your pain during flare-ups.
- Referral to cognitive behavioral therapy (a type of talk therapy) to help you better understand your pain and teach you how to manage back pain.
- Prescribe nonsteroidal anti-inflammatory and nerve pain medications.
- Recommend an epidural spinal injection (ESI), which involves injecting medicine directly into the space around your spinal nerves or spinal cord.
If the pain does not respond to these treatments, or you lose movement or feeling, your doctor may recommend surgery to relieve pressure on the nerves or spinal cord. Surgery may include removing a bulging disk, removing part of the vertebra bone, or widening the opening where your spinal nerves are located.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.